Newtown: A Public Health Law Perspective

This post is part of a series “Healing in the Wake of Community Violence: Lessons from Newtown and Beyond,” based on an event of the same name hosted at Harvard Law School in April 2017. Background on the series and links to other blog posts are here.

By Wendy E. Parmet

No man is an island

Entire of itself,

Every man is a piece of the continent,

A part of the main

—John Donne, 1624

Like John Donne’s famous Meditation XVII, Newtown, Kim Snyder’s documentary about the aftermath of the 2012 massacre at the Sandy Hook elementary school in Connecticut, forces us to reflect on the inter-connectedness of human life. As Newtown shows with power and poignancy, the victims of that awful massacre were not islands. They were a part of a continent comprised of their families, friends, community, and indeed, all who recall the awful day they were killed.

parmet-chartThis inescapable reality, that our lives and deaths can affect and even traumatize others, is perhaps sufficient to proclaim that gun violence is a public health problem. None of the over 30,000 Americans who die each year from gun violence (most by suicide), are islands. Nor are any of the over 78,000 Americans who are injured by firearms. All are part of the continent. Gun violence affects us all.

But gun violence is a public health problem for another, equally important reason. As with other public health problems, from obesity to HIV/AIDS, the risk that individuals face with respect to firearms is influenced significantly by factors that lie outside their own control. This is not simply because the victims of the Sandy Hook massacre did nothing, and could do nothing, to cause their own death. It is also because different populations face different levels of risk. Race, age, income, gender, geography and a host of other variables determine one’s risk of dying or being injured by firearms. 

The population-based nature of the threat—the fact that the risk of firearm violence varies dramatically for different populations—presents a paradox evident throughout the film. Although Newtown teaches us that the tragic loss of a few can cause trauma to many, it leads us to this understanding by showing us the faces of three children who died and sharing the memories of their grief-stricken parents and neighbors. This very intimate portrayal of the Newtown families opens the door to our (emotional) recognition that gun violence has a broader, community-wide impact. In effect, by seeing the pain of discrete individuals, we are able to understand the trauma of wider populations.

parmet-mapStill, the focus on individual victims, or even a single community’s pain, can mislead us about the scope and nature of gun violence. From a population perspective, the Newtown victims were highly atypical. They lived in Connecticut, one of the safest states in the United States in terms of gun violence. They were also white. According to the Brookings Institute, between 2011 and 2013, black men were more than four times more likely than white men and approximately eight times more likely than white women to be killed by guns. For whites, the vast majority of gun deaths (over 77%) come from suicides; for blacks, the vast majority (over 82 %) are homicides. Moreover, the type of lone-shooter mass shooting that occurred in Sandy Hook remains, thankfully, extremely rare. Indeed, its rarity probably helps to explain why it is so disturbing, as we tend to become desensitized to more common, everyday risks.

To think more broadly about gun violence, to adopt a public health perspective, we need to look beyond Newtown and ask why different populations face different risks. Asking that question will lead us to think about the social, economic, and environmental factors, the so-called social determinants of health, that influence population health.

Importantly, law is one social determinant that can affect the health risks faced by varied populations. In the case of firearms, laws pertaining to the sale, ownership, and use of guns almost surely play a large, albeit complex, role in explaining the prevalence of gun-related morbidity and mortality in the U.S. For example, although the U.S. has similar rates of violent crime and attempted suicides as many other wealthy countries, it has dramatically higher rates of firearm homicides or suicides. Many public health experts believe that lax gun regulations in the U.S. may help to explain some of that difference. To say that is not to state that any particular gun law (including the Supreme Court’s interpretation of the Second Amendment) increases or decreases the rate of firearm violence. Rather, it is simply to assert what the parents of Newtown understood: laws can affect the social environment. This means that legal changes have the potential to alter the risks that populations face, either in good or troubling ways.

In 1988 the Institute of Medicine defined public health as “what we, as a society, do collectively to assure the conditions for people to be health.” As Snyder’s documentary makes clear, the families of Newtown recognized this, as they sought to heal their wounds by working for collective change in the nature of law reform. Their efforts did not bear fruit in Washington, as federal gun control efforts died in Congress. But in the wake of the Sandy Hook massacre, the state of Connecticut passed legislation that barred the sale of high capacity gun magazines and expanded the number of guns covered by the state’s assault weapons ban. Thus individual grief and community trauma can lead to collective mobilization and ultimately law reform. Perhaps, therefore, it isn’t surprising that researchers have found a 15% increase in the number of firearms-related legislation introduced in the 12 months following a mass shooting. Interestingly, so-called blue states responded by toughening their gun laws while red states relaxed those laws.

Still, dangers arise when we use the tragedies of discrete individuals such as in Newtown to guide public health policymaking, as we so often do (consider the common practice of naming a law for an individual victim). As noted above, mass shootings are, epidemiologically speaking, anomalous. They do not offer a representative picture of gun violence in the U.S. For public health policymakers and lawyers, this presents a significant challenge:  how to use the emotional power and mobilization for law reform sparked by tragedies such as the Sandy Hook shooting to develop solutions that address larger, population-level risks. Kim Snyder’s film doesn’t answer that question, but if anything can push us to seek it, it’s her film.

Watch Wendy Parmet’s full presentation, “Newtown: A Public Health Perspective,” on the Petrie-Flom Center’s website.

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